Ýnce Baðýrsakta Gastrointestinal Stromal Tümör, Servikal Metastazý: Olgu Sunumu

Gastrointestinal (Gl) stromal tumors (GISTs) are the most common mesenchymal tumors specific to the Gl tract, generally defined as KIT (CD117)- positive tumors with a characteristic set of histologic features. These tumors, derived from Cajal cells or their precursors, most commonly occur at the age > 50 years in the stomach (60%), jejenum and ileum (30%), duodenum (4-5%), rectum (4%), colon and appendix (1-2%), and esophagus (< 1%), and rarely as apparent primary extragastrointestinal tumors in the vicinity of stomach or intestines. Their overall incidence has been estimated as 10 to 20 per million. The most frequent complications associated with GISTs are obstructions and hemorrhages. Surgical resection is the primary treatment of GISTs. Radiotherapy and chemotherapy are generally ineffective. Continuous postoperative follow-up is necessary, becouse most recurrences ocur within the fýrst 2 years after complete surgical resection. Our case was a 63 years old male patient. He had an operation for an intestinal tumor in October 2003. The histological exa-mination revealed malignant gastrointestinal stromal tumor. He had no radiotherapy and chemotherapy. He had 4 years follovv-up without any problem. Ýn January 2007, he had a 3*3 cm right cervical mass. Cervical MRI showed a tumor on 5th cervical vertebra. He had a biopsy and its examination revealed gastrointestinal stromal tumor.

Gastrointestinal Stromal Tumor of the Intestine and Cen/ical Metastases: Case Report

Gastrointestinal stromal tümörler (GIST), gastrointestinal sistemin en sýk görülen mezenkimal tümörleridir. KÝT (CD117)-pozitifliði ile birlikte diðer bazý histolojik özellikleri ile tanýnýrlar. En sýk 50 yaþýndan sonra görülürler. Midede %60, jejenum ve Ýle-umda %30, duodenumda %4-5, rektumda %4, kolon ve apendikste %1-2, özefagusta %1'in altýnda görülür. Görülme sýklýðý milyonda 10-20’dir. GIST’lerde en sýk belirti obstrüksiyon veya kanamadýr. GIST'lerde primer tedavi cerrahi rezeksiyondur. Radyoterapi ve kemo-terapi genellikle etkisizdir. Postoperatif dönemde takip gereklidir, çünkü komplet cerrahi rezeksiyon sonrasýnda rekürrenslerin çoðu ilk 2 yýlda ortaya çýkar. Sunulan olgu 63 yaþýnda erkek hasta olup 2003 yýlýnda ince baðýrsak kökenli kitlesi öpere edildi. Postoperatif patoloji raporu malign GIST (jejenum) olarak geldi. Adjuvant radyoterapi veya kemoterapi uygulanmadý. Vakamýz 4 yýl boyunca sorunsuz takip edildi. Hastamýz Ocak 2007 yýlýnda sað boyunda 3*3 cm sert fikse kitle ile baþvurdu, servikal MRI'da servikal 5. vertebra hizasýnda kitle saptandý. Biyopsi sonucu GIST olarak geldi.